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Case Reports
. 2024 Feb 25;16(2):e54899.
doi: 10.7759/cureus.54899. eCollection 2024 Feb.

Transvaginal Isthmocele Repair With Temporary Occlusion of Uterine Vessels in Caesarean Scar Pregnancy

Shubhada Jajoo  1 , Suyash Naval  1 , Rucha Naval  2
Affiliations
Case Reports

Transvaginal Isthmocele Repair With Temporary Occlusion of Uterine Vessels in Caesarean Scar Pregnancy

Shubhada Jajoo et al. Cureus. .

Abstract

A uterine scar defect, or isthmocele, is one of the known complications of cesarean delivery. It can cause obstetric as well as gynecological problems. Diagnosis can be suspected based on complaints such as abnormal uterine bleeding, pelvic pain, dysmenorrhea, and subfertility. It can be investigated by transvaginal ultrasound and MRI hysteroscopy. A hysteroscopy gives a confirmatory diagnosis. Isthmoplasty may be offered to avoid future obstetric complications and treat symptoms. In the present case report, a patient with prolonged postmenstrual dark-colored spotting underwent isthmocele repair by a procedure that could be unique, which is transvaginal isthmocele repair with temporary occlusion of uterine vessels. This procedure offers efficacy, safety, good outcomes, and prospects. Cesarean scar pregnancy (CSP) is a rare but potentially serious complication of cesarean section deliveries. We describe the efficacy, safety, outcomes, and prospects of transvaginal Isthamocele repair with temporary occlusion of uterine vessels to manage CSP.

Keywords: caesarean; isthmocele; p foley catheter; uterine vessels occlusion; vaginal route.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Showing ultrasonography preoperative Isthmocele
Figure 2
Figure 2. Shows temporary occlusion of uterine vessels with Buldogs vascular clamps to minimize blood loss
Figure 3
Figure 3. After incision, the Isthamocele defect was repaired in two layers to achieve good strength of the scar postoperatively
Figure 4
Figure 4. Shows pediatric Foley's catheter is inserted in the uterine cavity to prevent adhesions and stenosis
Figure 5
Figure 5. Shows complete repair of defect in two layers
Figure 6
Figure 6. Showing ultrasonography post operative Isthmocele
Figure 7
Figure 7. Shows a diagrammatic representation of a scar defect
Figure credits: Dr. Shubhada Jajoo
See this image and copyright information in PMC

References

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